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Pathology -Small Bowel Infarction
Definition: Ischaemic necrosis of a section of the small intestine. Epidemiology • Typically observed in those over 50 years of age.
Aetiology • Thrombosis associated with an unstable atherosclerotic plaque in the superior mesenteric artery. • Thromboemboli originating from the left ventricle or left atrium. • Hypovolemia.
Pathogenesis A sudden decrease in blood flow through the superior mesenteric artery results in ischemic necrosis of a portion of the small intestine. Massive hemorrhage into the infarcted colon results in hypovolemia. Bacteria swiftly infiltrate the necrotic gut wall, resulting in sepsis.
Presentation: • Sudden onset of intense stomach pain accompanied by hematochezia and hypovolemia.
Macroscopy The infarcted small intestine exhibits a dusky purple hue. Upon incision of the intestinal segment, substantial quantities of blood are observed within the lumen, and the mucosal surface appears fragile and necrotic. Histopathology • Complete thickness necrosis of the intestinal wall
.
Prognosis • Timely laparotomy is crucial for the resection of the infarcted bowel segment. • Prognosis is typically unfavorable due to the swift onset of hypovolaemia and sepsis, leading to multiorgan failure.
Definition: Ischaemic necrosis of a section of the small intestine. Epidemiology • Typically observed in those over 50 years of age.
Aetiology • Thrombosis associated with an unstable atherosclerotic plaque in the superior mesenteric artery. • Thromboemboli originating from the left ventricle or left atrium. • Hypovolemia.
Pathogenesis A sudden decrease in blood flow through the superior mesenteric artery results in ischemic necrosis of a portion of the small intestine. Massive hemorrhage into the infarcted colon results in hypovolemia. Bacteria swiftly infiltrate the necrotic gut wall, resulting in sepsis.
Presentation: • Sudden onset of intense stomach pain accompanied by hematochezia and hypovolemia.
Macroscopy The infarcted small intestine exhibits a dusky purple hue. Upon incision of the intestinal segment, substantial quantities of blood are observed within the lumen, and the mucosal surface appears fragile and necrotic. Histopathology • Complete thickness necrosis of the intestinal wall
.
Prognosis • Timely laparotomy is crucial for the resection of the infarcted bowel segment. • Prognosis is typically unfavorable due to the swift onset of hypovolaemia and sepsis, leading to multiorgan failure.
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